Osberger M J, Fisher L, Zimmerman-Phillips S, Geier L, Barker M J
Advanced Bionics Corporation, Sylmar, California 91342, USA.
Am J Otol. 1998 Mar;19(2):152-7.
The primary purpose of this study was to determine if children, > or =5 years old, with onset of deafness before the acquisition of spoken language (i.e., prelingually deafened) derived more benefit from multichannel cochlear implants than from conventional hearing aids. It was hypothesized that children who used oral communication (speech plus listening) would demonstrate higher levels of performance after implantation than children who used total communication (English sign system plus speech and listening).
Previous research suggests that prelingually deafened children given implants at an older age derive limited benefit from these devices. Changes in candidacy criteria and advances in technology, however, may make cochlear implants a more viable treatment option for this group of patients.
A repeated-measures design was to used to compare patients' preoperative performance with hearing aids to postoperative performance with the CLARION cochlear implant after 3 and 6 months of device use. Pre- and postoperative performance were analyzed separately for children who used oral and total communication.
Both groups of children (oral and total communication) demonstrated significant postoperative improvement on all outcome measures over time. Postoperative scores of the children who used oral communication were significantly higher than those of the children who used total communication on four of the five outcome measures.
Prelingually deafened children who do not receive cochlear implants until > or =5 years of age derive significant benefit from current implant devices compared with that obtained with conventional hearing aids. The greatest benefit is derived by children who use oral communication, with much more limited benefit demonstrated by children who use total communication.
本研究的主要目的是确定5岁及以上在获得口语之前就开始耳聋（即语前聋）的儿童，从多通道人工耳蜗植入中获得的益处是否比传统助听器更多。据推测，使用口语交流（言语加听力）的儿童在植入后表现出的性能水平将高于使用全面交流（英语手语系统加言语和听力）的儿童。
先前的研究表明，语前聋儿童在较大年龄植入人工耳蜗后从这些设备中获得的益处有限。然而，候选标准的变化和技术的进步可能使人工耳蜗成为这组患者更可行的治疗选择。
采用重复测量设计，比较患者术前使用助听器的表现与术后使用CLARION人工耳蜗3个月和6个月后的表现。对使用口语和全面交流的儿童分别分析术前和术后表现。
两组儿童（口语和全面交流）随着时间的推移在所有结果指标上均显示出术后显著改善。在五项结果指标中的四项上，使用口语交流的儿童术后得分显著高于使用全面交流的儿童。
与传统助听器相比，如果语前聋儿童直到5岁及以上才接受人工耳蜗植入，他们从当前的植入设备中能获得显著益处。使用口语交流的儿童受益最大，而使用全面交流的儿童受益则非常有限。
